Late last year, 10 of Canada’s nursing regulatory bodies selected an American organization, the National Council of State Boards of Nursing, to develop a new examination for entry-to-practice which will replace the current Canadian exam by 2015. The NCLEX (National Council Licensure EXamination) is the name of the exam currently used in the United States.
There has been a lot of talk lately about the NCLEX coming to Canada. To be honest, when I first heard about it my thought was, “that doesn’t sound completely terrible”.
I have taken both the Canadian Registered Nurse Examination (CRNE) and the NCLEX and I have to say that the NCLEX was a much harder exam, yet easier to study for. The CRNE is very psycho-social based, whereas the NCLEX is more pathophysiology based. Questions on the CRNE can often be argued to have more than one answer, whereas the NCLEX requires a clear answer…. you just have to know what it is.
I have long thought that we need to reform the CRNE. There is an urban legend within nurses that a group of professionals (lawyers, engineers, etc) took the Examination and 60-70 per cent of them passed. While this may or may not be true, it suggests that the CRNE does not do justice to the specialized body of knowledge that nurses have.
The major criticism being leveled against this new plan is that the content will not be Canadian. Quite frankly, anyone who believes that the NCLEX is going to be implemented “as is” in Canada is being naive and foolish. The exam will have to reflect Canadian content in order to license nurses in Canada, and the licensing bodies that have chosen to pursue this option know that. For example, one area of the exam that would absolutely need to be edited would be lab values, due to the different units of measurement used in some of the U.S. lab work (e.g. blood glucose).
When it comes to content, I have heard concerns about the differences between private versus universal healthcare. While payment for healthcare does differ between Canada and the U.S., the structures of primary health care and hospitals are quite similar. Besides, I cannot remember a single question on the exam or in any of my studying that contained information on insurance options or payment (if anyone has a different experience, please note it in the comments below).
There are many advantages to bringing an NCLEX style exam to Canada.
- It is computerized. There would be no need to print out hundreds of exams, or organize testing spaces (already established testing facilities would likely be used). Furthermore, content could be updated faster to reflect current research and practices.
- Flexibility. Nurses would be able to take the exam whenever a testing facility had an open space, rather than the four arbitrary days that are currently available. Nurses would no longer have to wait another three months to take the exam if they are unable to make it on a particular day.
- The exam is “smart”. A computerized smart exam is more effective at determining a nurse’s competency because it will continue to ask questions until it knows within a certain statistical certainty that the writer does, or does not, know the content.
So, do I want the NCLEX to become the standard for testing Canadian nurses? Absolutely not! Do I want a computerized, pathophysiology-based, difficult exam which reflects nurses’ unique knowledge? Absolutely!
Rather than fight this process, let us use it as an opportunity to reform the exam and ultimately have it reflect our amazing profession.
The views and opinions expressed in this post do not necessarily reflect the views and opinions of the ARNBC.
Nickie Snyder is an ICU RN for Fraser Health and also helps with their new graduate nurse workshops. A dual Canadian/US citizen, Nickie lives in the US, works in Canada, completed her undergraduate degree in nursing in Canada and is currently enrolled in a combined Masters and Doctorate of Nursing Practice program at the University of Washington. Nickie plans on becoming a Nurse Practitioner, and hopes to teach nursing as well. Dynamic, energetic, and passionate about nursing, Nickie loves to share about her experiences and advocate for the nursing profession. She is also a social media addict and can be found at www.twitter.com/missnickie